Healthcare Provider Details

I. General information

NPI: 1417053737
Provider Name (Legal Business Name): SATISH MAHNA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5311 NORTHFIELD RD STE 308
BEDFORD HTS OH
44146-1102
US

IV. Provider business mailing address

23620 HALBURTON ROAD
BEACHWOOD OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 216-577-0224
  • Fax: 216-663-5006
Mailing address:
  • Phone: 216-577-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number35-053450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: